Can I reattach a used stoma (stomah) bag and how often should it be changed?

Stoma Bag Management: Reuse and Change Frequency

Stoma bags should not be reattached after removal as they are designed for single use only, and bags should typically be changed every 1-3 days depending on the type of stoma and output.

Single Use Design and Safety Concerns

• Stoma bags are classified as single-use medical devices and should not be reused after removal 1
• Reprocessing and reusing single-use medical devices without proper validation studies may transfer legal liability from the manufacturer to the user or their organization 1
• Reusing single-use items may expose patients to risk and could constitute a criminal offense under health and safety regulations 1

Recommended Change Frequency

• For colostomy bags (formed stool):

  • Closed bags should typically be changed 1-3 times per day 2
  • The bag should be changed when it is 1/3 to 1/2 full to prevent leakage and skin complications 3

• For ileostomy bags (loose output):

  • Drainable bags should be emptied when 1/3 to 1/2 full 3
  • The entire appliance should typically be changed every 2-3 days 2

• For urostomy bags (urine):

  • Bags should be emptied regularly throughout the day 3
  • The entire appliance should be changed every 2-3 days 2

Proper Stoma Care During Changes

• Assess the peristomal skin during each bag change for signs of irritation, breakdown, or infection 1
• Clean the stoma and surrounding skin gently with warm water (avoid soaps with moisturizers) 4
• Ensure the skin is completely dry before applying a new barrier and bag 4
• Measure the stoma size regularly (especially in the first 8 weeks after surgery) to ensure proper fitting of the appliance 2

Preventing Complications

• Apply zinc oxide-based skin protectants if there is evidence of peristomal leakage to protect the skin 1
• Consider using barrier films or creams if skin irritation is present 3
• Ensure proper tension between the internal and external fixation devices to prevent buried bumper syndrome in patients with gastrostomy tubes 1
• For patients with high-volume or liquid output, consider using convex barriers for a better seal 5

Important Considerations

• Disposable products are preferred over reusable ones to minimize infection risk 1
• If leakage occurs frequently, reassess the fit of the appliance and consider consulting with a stoma nurse 3
• Complications such as skin breakdown can occur if bags are changed too infrequently or if there is prolonged contact between output and skin 6
• Patients with stomas that produce enzymatic output (like ileostomies) require more frequent assessment for skin integrity 3

Pitfalls to Avoid

• Never reattach a used stoma bag as this increases infection risk and compromises the adhesive seal 1
• Avoid excessive cleaning or use of products containing alcohol, as these can irritate the peristomal skin 4
• Do not wait until the bag is completely full before emptying or changing it, as this increases risk of leakage 2
• Avoid using standard gauze for dressing peristomal skin issues, as foam dressings are better at lifting drainage away from the skin 1